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A nationwide analysis of incidence and outcome of breast cancer in the country of Surinam, during 1994–2003

  • Epidemiology
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Abstract

In this study, we describe the incidence, treatment, and outcome of breast cancer (BC) during the period 1994–2003 in the South-American country of Surinam and compare these with those of BC in the Netherlands. Pathology reports and hospital charts from all BC cases diagnosed between 1994 and 2004 were retrieved from Surinam’s single pathology laboratory and its five hospitals. Data on demographics, tumor characteristics, treatment, and follow-up were gathered. We compared our data to BC statistics of first generation immigrants from Surinam to the Netherlands. 421 patients were diagnosed with BC during the study period. The age-adjusted incidence rate was 26 per 100,000 compared to 65/100,000 in first generation Surinamese women in the Netherlands. The majority had a fairly advanced stage at presentation, with 60% of tumors larger than 2 cm, and 41.6% with lymph node involvement. Because of the absence of radiotherapy facilities, local treatment in most patients was radical mastectomy. Adjuvant hormonal therapy (51.6%) was administered more frequently than adjuvant chemotherapy (20.3%). A significant number of patients were lost to follow-up, resulting in a median follow-up duration of only 23 months. The 5-year overall survival was 79%. BC incidence in Surinam is low compared to that in the western world, but the advanced stage at diagnosis, the low utilization of systemic adjuvant therapy, and the inadequate follow-up may lead to poor outcomes. A number of steps are underway to improve the level of cancer care in Surinam.

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Acknowledgments

The authors are very grateful for the participation and assistance of all the persons and institutions in this study, as listed under Appendix.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Medicine, VU University Medical Center, Amsterdam, The Netherlands

    Rachel S. van Leeuwaarde

  2. Department of Internal medicine, UMC Utrecht Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands

    Rachel S. van Leeuwaarde

  3. Department of Pathology, Academic Hospital of Paramaribo, Paramaribo, Surinam

    Martinus A. Vrede & Floyd Henar

  4. Department of Surgery, Diakonessen Hospital, Paramaribo, Surinam

    Rob Does

  5. Department of Internal Medicine, ‘s Lands Hospital, Paramaribo, Surinam

    Philip Issa

  6. Department of Surgery, St Vincentius Hospital, Paramaribo, Surinam

    Emmett Burke

  7. Comprehensive Cancer Center, Amsterdam, The Netherlands

    Otto Visser

  8. Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands

    Frank Rijmen

  9. Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands

    Anneke M. Westermann

Authors
  1. Rachel S. van Leeuwaarde
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  2. Martinus A. Vrede
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  3. Floyd Henar
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  4. Rob Does
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  5. Philip Issa
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  6. Emmett Burke
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  7. Otto Visser
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  8. Frank Rijmen
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  9. Anneke M. Westermann
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Corresponding author

Correspondence to Rachel S. van Leeuwaarde.

Appendix

Appendix

Surinam: Boards of hospitals and medical staffs.

Ministry of health: M. Eersel, MSc

Administrative staff of all participating hospitals

Paramaribo, Surinam:

Academisch Ziekenhuis

Surgery: R.B. Girjasing, MD. S. Nannan Panday, MD

Internal medicine: H.D. Chee, MD C.H. Adhin, MD, I.J. Lie Kiauw, MD J. Loor, MD, J.E. Anijs, MD

Diakonessenhuis

Surgery: A.E. Bergen MD

Internal medicine: S. Vreden, MD, E. Dams, MD, B.O. Hewitt, MD, M. van Eer, MD

‘s Lands Hospital

Surgery: J.H. de Bye, MD

Internal medicine: S Nannan Panday†, MD

St Vincentius Hospital

Surgery: M.N. Mohab Ali, MD

Internal medicine: A. Cameron, MD H. Dissels, MD

Nickerie, Surinam:

Streekziekenhuis Nickerie

Surgery: A.S. Li Fo Sjoe, MD

Pediatrics: N. Braafheid, MD

Vu medical center, Amsterdam, The Netherlands

W.R. Gerritsen MD, PhD

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van Leeuwaarde, R.S., Vrede, M.A., Henar, F. et al. A nationwide analysis of incidence and outcome of breast cancer in the country of Surinam, during 1994–2003. Breast Cancer Res Treat 128, 873–881 (2011). https://doi.org/10.1007/s10549-011-1404-7

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  • DOI: https://doi.org/10.1007/s10549-011-1404-7

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